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Questions and Answers
What does population health primarily focus on?
Which component is essential for decision support in diabetes care?
Which strategy is aimed at improving self-management support in diabetic patients?
What role do community resources play in population health?
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What is a potential barrier to effective diabetes self-management?
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How does the chronic care model (CCM) aim to enhance diabetes care?
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What is emphasized in a quality-oriented health system regarding diabetes care?
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Which aspect of managing diabetes would NOT typically be included in population health strategies?
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What BMI percentile qualifies a child or adolescent as obese?
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When should a provider closely monitor a patient with prediabetes?
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What is the range for A1C levels that indicate prediabetes?
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What fasting plasma glucose level indicates diabetes?
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How frequently should individuals with prediabetes be monitored for the development of type 2 diabetes?
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What should be the next step if there are discrepancies between measured A1C and plasma glucose levels?
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What oral glucose tolerance test range indicates prediabetes?
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Which scenario would require two abnormal test results to confirm a diabetes diagnosis?
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What should people being considered for metabolic surgery be evaluated for?
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What kind of approach should guide the choice of pharmacologic agents for patients?
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What treatment is recommended for type 2 diabetes patients with established ASCVD or high-risk indicators?
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What is the preferred treatment for patients with type 2 diabetes who need more glucose lowering than can be obtained with oral agents?
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What should people who undergo metabolic surgery be routinely evaluated for?
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Which factor is NOT considered when choosing pharmacologic agents?
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What psychological aspects should be assessed before metabolic surgery?
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Which type of regimen is recommended for most people with type 1 diabetes?
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Which therapy is recommended for patients with ASCVD or other CV risk factors who have elevated triglycerides?
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In which scenario is aspirin usage for primary prevention most strongly recommended?
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What is the primary reason for caution in using statin plus niacin combination therapy?
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What major risk factor is NOT considered when recommending aspirin for primary prevention?
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What adverse effect is associated with combination therapy using statins and niacin?
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Which patient population shows a modestly increased risk of incident diabetes with statin use?
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Why is the net benefit of aspirin in primary prevention considered controversial?
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What is a reason for not recommending statin plus fibrate therapy?
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What is the recommended A1C test frequency for patients who are meeting treatment goals?
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How often should the A1C test be performed in patients whose therapy has changed?
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What is the primary advantage of point-of-care testing for A1C?
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What should be considered as a standard printout for all CGM devices?
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What A1C goal is generally considered appropriate for many nonpregnant adults?
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Which factor is associated with the risk of microvascular complications?
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When might less stringent A1C goals, such as below 8%, be appropriate?
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What is an acceptable endpoint for clinical trials related to glycemic control?
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Study Notes
Proactive Care Delivery System
- A coordinated, team-based approach enhances patient care through planned visits.
- Focuses on improving community health and outcomes for populations with chronic conditions, such as diabetes.
Improving Care and Promoting Health
- Self-management support empowers patients to manage their conditions effectively.
- Decision support utilizes evidence-based care guidelines to standardize treatment approaches.
- Clinical information systems leverage registries for patient-specific and population-level health data.
Population Health and Diabetes
- Population health assesses health outcomes in groups, focusing on the distribution of health and wellness.
- Emphasizes early intervention in individuals with prediabetes or conditions related to obesity.
Diabetes Screening and Diagnosis
- Criteria for prediabetes: A1C 5.7–6.4%, fasting plasma glucose 100–125 mg/dL, oral glucose tolerance test 140–199 mg/dL.
- Criteria for diabetes: A1C ≥6.5%, fasting plasma glucose ≥126 mg/dL, oral glucose tolerance test ≥200 mg/dL, random plasma glucose ≥200 mg/dL with symptoms.
- Monitoring for diabetes development is recommended at least annually for those with prediabetes.
Glucose Monitoring and Assessment
- A1C tests should be conducted biannually for stable patients, quarterly for those with treatment changes.
- Continuous Glucose Monitoring (CGM) offers advanced metrics and visual reports for better treatment guidance.
A1C Goals and Treatment Decisions
- Recommended A1C goal for many adults is <7% (53 mmol/mol) to reduce complications.
- Lower A1C targets may be appropriate for some patients, taking into account safety and individual circumstances.
Metabolic Surgery Considerations
- Evaluation for psychological and social factors is vital prior to metabolic surgery.
- Post-surgery mental health support is recommended for effective adjustment to lifestyle changes.
Pharmacologic Approaches to Glycemic Treatment
- Type 1 diabetes treatment typically involves multiple daily injections (MDI) or continuous subcutaneous insulin infusion (CSII).
- For type 2 diabetes, GLP-1 receptor agonists are preferred to insulin for additional glucose control.
Cardiovascular Risk Reduction
- Aspirin use is effective in reducing cardiovascular morbidity for high-risk patients with prior events.
- CVD risk factors warrant careful screening for diabetes, especially in patients on statins, given potential diabetes risk.
Combination Therapy Recommendations
- Combining statins with other therapies (such as fibrates or niacin) has not shown significant benefits in ASCVD outcomes.
- Assess individual risk factors carefully when deciding on the use of aspirin for primary prevention.
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Description
This quiz explores the proactive care delivery system focused on coordinated team-based approaches to improve care and promote health. It covers key topics such as self-management support and evidence-based decision-making in healthcare. Test your knowledge on these essential elements of healthcare delivery.
